SUNDARA MHS LLC – NPI #1730924580
Clinic/Center

SUNDARA MHS LLC is an AHC clinic located in BLUFFDALE, UT. NPPES has assigned the NPI number 1730924580 to SUNDARA MHS LLC on June 25, 2024. It is a Type-2 NPI, indicating this NPI number is associated with an organization. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 261QM1300X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Multi-Specialty

The NPI profile was last updated on May 28, 2025. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for SUNDARA MHS LLC below.

NPI Profile for
SUNDARA MHS LLC

NPI Number
1730924580
Enumeration Date

(about 2 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
SUNDARA MHS LLC
Primary location
14629 S PORTER ROCKWELL BLVD
BLUFFDALE, UT 84065
Phone: (801) 410-1100 Fax: (801) 332-9577
Mailing address
7533 S CENTER VIEW CT STE N
WEST JORDAN, UT 84084-5526
Phone: Fax:
Organization Subpart
No
Authorized Official
TAMARA BROADHEAD
MEDICAL DIRECTOR
Phone: (817) 319-9475
Updated
Certification Date
May 28, 2025

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QM1300X
- Clinic/Center / Multi-Specialty (Primary)
363LP0808X
- Nurse Practitioner / Psychiatric/Mental Health

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.